Category Archives: high blood sugar

The Sugar Finger

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Sticky fingers. Finger lickin’ good. Finger food. Wrapped around your finger. Can’t put your finger on it. Fingers crossed. Finger on the pulse. Butter fingers. Point the finger. Finger on the button. Slip through your fingers.

We have a lot of finger phrases. I have a new another one to add to the list:

Sugar finger: the finger that when checking your blood sugar with a finger stick, results in a consistently and significantly higher blood sugar reading than the other fingers.

I saw one definition online calling the middle finger the sugar finger, which is also fitting because I definitely wanted to give my meter the middle finger. Twice now, I’ve checked my blood sugar on one finger and was shocked by the high number. Something in my gut told me this wasn’t right (and of course this happens when my sensor is updating, or warming up, or already at the top of the graph so it couldn’t be counted on). So I washed my hands and checked another finger on the other hand. Sure enough it was at least a 100 points lower. So I check a third one just to be sure that the lower reading is accurate. Yup, it’s confirmed. I’ve had fingers be off before, but never so drastically, and two different days. I’m just glad that I didn’t correct based on the higher, inaccurate reading.

Right hand, index finger. The sugar finger.

Taking that finger out of rotation for a little while.

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Out-of-sync

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I remember when I was first diagnosed, the doctor said to me, you’re going to know your body extremely well, better than a lot of people who don’t have diabetes know their own bodies. She was referring to the fact that diabetics are constantly attuned to how they’re feeling, and noticing if anything feels different or off. Not to say that other people aren’t also aware of how their body feels and reacts. But over time, you get to know yourself and your body so well that you can pretty accurately guess what your blood sugar will be before checking.

Most of the time, I’m pretty in sync with my body and how I’m feeling. “I think I’m dropping low” usually is followed by the buzzing of my pump telling me that this is in fact true. But there are occasions when this balance gets out of whack. And when it does, it’s definitely a disorienting experience, when how you’re feeling doesn’t match to what you’re used to. This has happened to me a few times recently.

The most recent example happened this week. I was on my way to speak on an alumni panel for the undergrad psych department for students interested in the field of public health, talking about my career path and how I use my psych degree in my work. Although I’ve done some public speaking arrangements, I still get anxious before hand. As I walked towards the building, I could feel my heart pounding, my hands sweating. “Am I nervous or am I low?” It’s a question I was used to asking, I remember having the same feeling before job interviews or big presentations. I checked my CGM, it was right around 100. Just nerves.

I’ve learned that any time I use my inhaler, after about 10-15 minutes, my body starts to feel like it’s low. My hands get shaky, my heart beats faster. The first few times it happened I was convinced I had low blood sugar, it was the only time I had experienced the same symptoms so suddenly. But when I checked my blood sugar, it wasn’t low. Now I know to expect this, but even so, it’s still a confusing feeling.

Sometimes in my bootcamp exercise class, when the workout is extra intense, there’s this moment where I have to ask myself, am I struggling because I’m tired and this is a difficult workout or am I low and lacking the energy I need for this? I always stop and check my blood sugar. Usually I am in fact low, or dropping low, but sometimes my blood sugar is fine, and it’s just an exhausting and challenging workout. Sometimes it’s hard to tell the difference.

Finally, usually a tip off that my blood sugar is high is when I have to go to the bathroom more often than usual. So when this happens for other reasons like too much coffee or staying extra hydrated, the thought always crosses my mind: Is this normal or is my blood sugar high?

I definitely think that being familiar with how your body typically feels and reacts is beneficial for anyone. It can help you know when something is wrong sooner if you’re paying attention and it can help you make adjustments if you notice that your body is reacting poorly to something you’re doing or eating, for example. But it’s impossible to be correct 100% of the time, which is why I’ve learned to anticipate situations like the ones above where what I feel might not reflect my actual blood sugar. Then at least if I am wrong, I’m not caught completely off-guard.

You put the “um” in “numbers”

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“What do the numbers say?”

Numbers are often seen as this objective piece of data. And because they are objective, they cannot lie, right? We might not always like what they tell us, and they don’t always tell the complete story, but they’re often hard to argue with. How’s my blog doing? Well let me check the analytics and number of viewers. How’s my health doing? Well let me check my blood work: my blood pressure, my cholesterol numbers, my A1c. Success criteria is often operationalized in numbers. Who won the race? Let’s check the times. Who won the game? Let’s check the score.

You learn to trust the numbers. And while you can interpret the numbers differently, put them into context, explain the variance or trends with outside information and external variables, the numbers are what they are.

You start to crave the numbers. If some numbers are good, more must be better. I recently switched to a smart scale. I wasn’t just content with knowing my weight, I wanted to know my body fat percentage and my muscle mass percentage too. More numbers could help elucidate what’s really going on in my body and alleviate any uncertainty. If I’m working out more, but I’m gaining weight, I would feel much better knowing the weight was coming from more muscle mass and not body fat.

You rely on the numbers. They show your progress. They show your weaknesses and your strengths. The numbers are your guideposts.

So imagine how you’d feel if those numbers fail you. When all of the sudden, they can’t be trusted. And instead of helping you, they lead you astray.

Lost? Frustrated? Angry? Disappointed?

That’s how I felt as I returned home from my 3 month endo appointment this week. In the past 3 months I’ve had one major change, I switched insulin pumps and continuous glucose monitors. I was having so many issues with the sensor leading up to the appointment. It would suddenly stop working after only 1 to 2 days, it was inaccurate compared to my finger tests, the trending arrows were completely misleading. I told my doctor these problems, but I was still optimistic. After all, I had started eating healthier, been more consistent with my metformin to help with blood sugar spikes, I didn’t feel like my A1c should have been much different from 3 months earlier. But I was wrong. Those inaccurate numbers had contributed to my A1c going up .6 of a point. This may not seem like much, but when you are trying to get below a certain number and are at the lower end, to suddenly be back at the higher end is very discouraging.

numbersAll day I alternated between being livid and just feeling sad. I felt let down by the numbers I rely on every minute of the day to be healthy. By the end of the day, I made the decision to switch back to my old, reliable sensor. Enough is enough. My health shouldn’t be made worse by the devices that are meant to improve it.

Numbers are complicated. So is having diabetes. And that means being critical of the numbers, always. Because what is meant to be helping you could actually be making things worse if you aren’t careful.

 

 

 

Lessons from Levi

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My foster dog Levi and I spend a lot of time together. Since I work from home, he’s constantly curled up next to me, usually sleeping while I’m working. They say that owners and their pets sometimes start to resemble one another over time. I’d definitely say that’s been true of Levi and I.

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There’s a lot we can learn from our pets. In fact, I found a great list on Huffington Post of what dogs can teach us about what matters most. They remind us to live in the moment, to not hold grudges, to be loyal and dependable, and to love unconditionally.

Yesterday though, I found myself imitating Levi in a completely different way.

It was after my bootcamp class. My blood sugar was on the rise, but this was to be expected since this particular fitness class always seems to raise my blood sugar an hour later. Anticipating this rise, I had given a few units of insulin once class ended. I ate dinner, giving another bolus. But it was as if I was delivering water instead of insulin, it wasn’t doing anything to stop my rapidly rising blood sugar! By 9:30 pm I found myself staring at a staggeringly high number, the highest I’ve seen in a very very long time. I changed my infusion set and gave a correction through an injection.

At this point in the night, I was feeling truly miserable. I was thirsty, nauseous, my body and head ached, my brain felt foggy. But it was the end of the night and I had to take Levi out before bed.

LeviDance.gifThat’s when I realized that Levi was doing exactly what I needed to be doing! Tonight, I would channel my inner dog and follow Levi’s example.

Excited to be outside, Levi started pulling me to walk faster. Alright I got it, we’ll pick up the pace! Exercise, including walking, can be beneficial in lowering blood sugar. Great thinking, Levi.

While on our walk, Levi kept stopping to sniff and pee every 10 feet. While stopping so often on a walk is annoying, frequent urination to flush out your system is important when dealing with high blood sugars or even small amounts of ketones. Smart thinking again, Levi.LeviDrink.gif

When Levi finally finished emptying his bladder and marking every pole we passed, we went back inside. Levi made a dash straight for his water dish, lapping up the entire bowl. Drinking lots of water! This can help the kidneys flush out the extra glucose in the blood. Great and important advice, Levi!

I checked my blood sugar again, finally it was coming down! The rapidly dropping arrows confirmed that I was trending in the right direction and I was starting to feel a little bit better.

With the worst behind me, I followed Levi’s lead one last time that night.

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By 12:30 am, my blood sugar was back to normal. Thanks for all the lessons, Levi!

 

Balancing bouquets and blood sugar

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You know that feeling you get when you forget your phone? It’s that uncomfortable, anxious, itch that leaves you feeling like a little piece of you is missing. Well this past weekend, I experienced a similar feeling, but it wasn’t my phone that I was without, it was my all my diabetes supplies.

This past weekend was my first experience being a bridesmaid in my friends’ wedding. What an incredible experience it was! The wedding was so beautiful and I was honored to be a part of it. But one piece I did have to think and plan ahead of time was what I would do in the event that my blood sugar dropped low during the ceremony. You see, the 20-30 minute ceremony was the only part of the night where I wouldn’t have immediate access to my purse and thus my meter, CGM, and fruit snacks. I had no pockets or place that I could easily access to put my fruit snacks. And it’s not that I haven’t gone that amount of time being away from my supplies, it was more the fact that I would be standing in front of a crowded room of people, lined up among the bridesmaids. Granted, everyone would be looking at the bride and groom and not me if I did have to step away and treat a low, but I really didn’t want to cause any type of disruption or set myself apart from the rest of the bridal party. I wanted it to be perfect for my friends.

imageBut part of having type 1 diabetes is always being prepared for an emergency and always putting your health first. So I was determined to come up with a solution.  My plan was to keep my blood sugar a little elevated during the ceremony, just to be safe. However that did not work as planned. Instead, I was fighting sky high blood sugars all during the day, so there was a very real possibility that it could crash during the ceremony, despite my best efforts. I thought about hiding the fruit snacks in my bouquet, but the beautiful arrangement wasn’t able to adequately conceal them. The final solution: I took a plastic baggie and dumped the pack of fruit snacks in it. I knew the plastic bag would be less crinkly than the wrapper. Then I folded down the edges of the bag so I could easily reach in for a gummy. Finally, I scrunched the bag as small as I could and held it in my hand, hidden within my grip on my bouquet of flowers. You couldn’t see them, but I felt secure knowing my fruit snacks were with me if worse came to worse. After all, it’s probably better to sneak a fruit snack during the ceremony than to pass out from low blood sugar  ;-).

Luckily I did not need my fruit snacks and the ceremony went perfectly. They don’t tell you when you’re diagnosed that you’re going to end up doing a lot of creative problem solving to make your diabetes fit your life. But not matter the situation, diabetes may be an extra consideration, but it will never stop you from living the life you want.

A scary situation (told using bitmojis)

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I recently found myself in a very scary situation as a diabetic. Let’s just say that I was about to drive myself to the hospital for my blood sugars, which I’ve never had to do before. Spoiler alert: I didn’t and everything is fine now, but it was still a frustrating and slightly alarming afternoon.

It started at my company picnic. It was a beautiful spring day and I was happy to be outside with my coworkers.

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But my blood sugar was high and rising fast.

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I had bolused for my lunch and figured it would eventually come back down. I was away from my CGM playing frisbee, running to catch it, and figured the activity would probably help lower it too.

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Not a frisbee, but closest I could find

After playing for close to an hour, I checked my CGM, but instead of my blood sugar going down, it was still going up.

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I corrected for the high giving more insulin and headed back inside to the office. My CGM started to point downward and I figured I was in the clear.

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As soon as I got back to my office, I went straight into a meeting. I sat there trying to pay attention to what was being said, but I was starting to feel nauseous and out of it. I felt so sick, I knew something had to be wrong.

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Luckily the meeting was short and I immediately checked my blood sugar number again, this time it had risen to over 500! I was shocked!

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I texted my dad and my sister (who is a nurse and soon to be a nurse practitioner) and filled them in. Then I rushed to the bathroom and gave myself a shot and changed my infusion set.

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I went and told my manager that I had to leave work early. I decided that if in one hour, my blood sugar wasn’t clearly going down, I would drive myself to the hospital. If all the insulin I had been giving wasn’t working, I knew I needed to get help.

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I got home and checked my ketones, which looked fine. Then I got a large glass of water and laid down on the couch, praying that my blood sugar would start to drop. About a half an hour later, I started to get some good news. And as it continued to fall, I gave my dad and sister a play-by-play.

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I was slightly bummed that I was missing my weekly bootcamp workout class, but I was just so relieved that my blood sugar was coming down. And as it dropped, I started to feel better physically too.

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I continued to lay on the couch, taking it easy as I watched my blood sugar fall. Soon it was dropping double arrows fast.  I started to worry that I may have given too much insulin and I was going to crash, which has happened many times before. I just wasn’t in the mood to be caught on a roller coaster of highs and lows.

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But finally, after about a total of 3 hours later, my blood sugar was almost completely back to normal and I could finally relax.

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So everything was fine and life went on, but it definitely was an experience that I hope never happens again!

Can I have a re-do?

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I often dread my endocrinologist appointments. But at the same time, I’m thankful for the 4 appointments each year. They’re forced moments of reflection, confrontation, and adjustment. Before each appointment, I consider how things are going. I know if the past 3 months have been good or bad. If it hasn’t been a good 3 months, it’s a time to confront myself and delve into why my numbers have been high or low or just all over the place. Sometimes it’s my own self-management habits that have slipped, other times it’s factors that are out of my control like getting sick. Then based on how things are going, I make adjustments along with my doctor and move forward.

Today was one of those appointments that I just wanted to get over with. The past month and a half has been rough. My numbers have been running high consistently. Between getting a pretty horrible cold that lingered, having to go on steroids for the sickness, stress from a breakup, adjusting to time changes of traveling, and then just a weird couple weeks where it seemed like my insulin wasn’t working as it normally does, I knew my doctor would be looking at some pretty awful numbers at our appointment.

Part of me is disappointed. I don’t like to be this off track. I don’t like knowing that I’m potentially doing lasting damage to my body, that I’m increasing my risk of complications. But I also know that life happens. There’s a lot that I can’t control and those events may unfortunately impact my health by way of my blood sugar. All I can do is my best to try to manage the consequences.

Diabetes is a chronic disease. It means that as of right now, I’m stuck with it for the long haul, it’s not going anywhere. And as much as I get caught up in these mini 3 month sprints between appointments, there’s a bigger picture. Three months is not very long when you look at a lifetime. And shit happens. There will be highs and lows in life just as there are in my blood sugar. I admit, I’ve had other things on my mind lately besides my diabetes and I’m sure that’s played a part. But I can’t control everything that happens, at some some point you have to let go and just do the best you can within your circumstances.

So yea, I’m not thrilled about this appointment and the past few months. But unfortunately there’s no re-do’s or rewinds with a chronic condition. What’s done is done. Now, I’m putting aside my excuses and focusing on moving forward.

 

Explanations

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I’ve learned over the years that I’m someone that craves explanations. I want things to make sense, I want to know why something may have happened. I need logic.
Granted, I don’t always need to know exactly why something happened, sometimes we just don’t know, but I find myself still wanting to make an educated guess. And when there is a disconnect between what happens and a proposed explanation, I get frustrated. “That’s impossible! There’s no way that what you just said could have caused that.” Those close to me are all too familiar with my need for logical conclusions, and my irritated response when I’m not satisfied with the answer.
But I know we don’t always get answers. Why do bad things happen to good people? Life is random, mysterious, and unpredictable at times, it’s part of what makes it both devastating and exhilarating. In many cases I’m perfectly content with the explanation that sometimes things happen that there are no logical explanations for, it’s the universe at work.

My diabetes falls somewhere in the middle.

Too many times I’ve found myself frustrated with a high or low blood sugar, not understanding why it happened when it seemed that I did everything “right” to avoid it. I rack my brain trying to come up with a logical explanation, but sometimes there are just too many variables to consider. Was I really that far off in my carb counting? Is this a delayed effect from the exercise I did earlier? Is something wrong with the insulin? Is there a bend in the tubing? Is the insulin not being absorbed at the site? Am I getting sick? Am I stressed? So much to consider, I can’t always draw a one-to-one connection for a high or low.

Last week I was shocked to see a blood sugar that was over 500. A rare event, my first thought was why?? Well really it was “Oh f*ck” but then why did this happen?!? I ran through the list in my head as I tested my ketones, gave myself a shot, and changed my infusion set.

You don’t always get answers for everything in life. I’ve learned to accept it and move on with the information that is available.

But sometimes, when you’re lucky, you get exactly the explanation you need.

bent infusion set cannula blocking insulin from being delivered

The Missed Meeting

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It was 10:28.

I was late. I was never late.

Every day at 10:15 we have a “stand up” at work, a quick standing meeting, sometimes just 15 minutes long, that I haven’t missed…until today.

10:28. How did I miss it? Oh yea, I remember.

Gigi had been acting up all morning, never really connecting and so not graphing my blood sugars. I had started the morning within my normal range, but at the higher end. But I was starting to feel pretty sick. With no help from Gigi, I tested my finger. 437! Shiiiiiiiiit.

I wasn’t sure how that had happened.. I went to the bathroom and first changed my set. It was close to being empty and I didn’t want to take any chances. Then I gave myself a shot. Since I don’t normally use syringes at work, I wondered if my workplace had a sharps container.

I walked to our front desk to inquire. “Do we happen to have a sharps disposal here?”

My question was returned with perplexing looks. “Like for…sharp…things?”

“Yea like needles.” Then I quickly added, “for insulin shots,” not wanting there to be any misunderstanding.

“No we don’t have one. But we can look into getting one.”

“Oh, it’s not a big deal, I can take it back home, I was just wondering.”

I started to walk away when the office manager stopped me. “Hey, one more thing. We are working on our emergency preparedness plan for the office. We are going to get cases of water, would orange juice be something that you would want us to get too?”

For some reason this question caught me by surprise. For as long as I can remember, I’ve always had to be prepared. I look out for myself, never knowing when a low blood sugar might strike. I guess I wasn’t expecting that my office would want to be prepared for me specifically as well. I thought back to a few months ago when we were all stuck in the basement for 3 hours during a tornado warning. I had a few packs of fruit snacks with me, but I did worry if I ran out. It would be reassuring knowing there would be an office emergency stash.

“Um actually yea, that would be great. Orange juice is perfect for low blood sugars. Thank you!”

“We’ll be sure to pick up some and look into the sharps container.”

I thanked her and walked away, glad that I work for a company that is so understanding and accommodating. I walked back to my desk, checked my blood sugar again, and looked at my clock.

10:28. Crap. I quickly emailed my coworker, apologizing for missing the meeting and explaining that I had some diabetes issues to take care of and lost track of time. It wasn’t a lie, but at the same time I try never let my diabetes be my excuse and didn’t like using it this time. I know my diabetes is disruptive. It wakes me in the middle of the night, it stops me in the middle of my workouts, it makes me rearrange my plans. But now it had gotten in the way of my work and made me miss a meeting. I was upset at myself for losing tack of time, even if I was taking care of my health, and hoped my coworker would understand.

Thankfully I had nothing to worry about. My coworker was more concerned with my health and wellbeing than with the fact that I missed the meeting. With my blood sugar on its way down, I hoped that the worst of the day was over.

I have to say how glad I am that I work in a place and with people that are so understanding of my health condition, I know that I’m lucky. And I know diabetes isn’t the only health condition that can get in the way of people’s productivity, everything from headaches and migraines to chronic pain, allergies, and stomach issues can be just as disruptive. But I hope that this was the last time that I’ll use my diabetes as an excuse and the last meeting I’ll miss because of it.